Follow-up after treatment for colorectal cancer

Follow-up after treatment is an important part of cancer care. Follow-up for colorectal cancer is often shared among the cancer specialists (oncologists), the surgeon and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

pain in the abdomen or pelvis

dry cough

fatigue

nausea

unexplained weight loss

difficulty going to the bathroom

The chance of colorectal cancer recurring is greatest within 5 years, so close follow-up is needed during this time.

Schedule for follow-up visits

Follow-up visits for colorectal cancer are scheduled based on your risk of recurrence and general health. Most people with colorectal cancer have follow-up visits every 3–6 months for 5 years after their first surgery.

People with stage 4 colorectal cancer who don’t have surgery, chemotherapy or targeted therapy don’t usually need regular follow-up visits.

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. Your doctor may do a physical exam, including:

feeling the abdomen

feeling lymph nodes in the chest, abdomen and pelvis

listening to the lungs

digital rectal exam (DRE)

You may also have the following tests as part of follow-up care.

Carcinoembryonic antigen (CEA) testing is done every 3–6 months for 5 years. An increase in CEA levels over time could mean the cancer has come back, or recurred.

Colonoscopy is done one year after surgery. If it is normal, then it is done every 5 years.

CT scan of the chest and abdomen is done to check for cancer in the lymph nodes, lungs and liver. It may be done every year for 3–5 years after surgery. If you were treated for rectal cancer, you may also have a CT scan of the pelvis to check for a local recurrence. People treated for stage 0, stage 1 or stage 2 colorectal cancer don’t usually need follow-up with imaging tests like CT scans.

Flexible sigmoidoscopy is done every 6 months for 2–5 years if you were treated for rectal cancer, especially if you didn’t have radiation therapy.

If a recurrence is found, your healthcare team will assess you to determine the best treatment options.